Recovering stroke patients whose physical therapy regimen is built around Wii video games appear to improve better than patients treated with standard therapies, a new Canadian study reveals.
The finding suggests that the enormously popular virtual reality programs could move beyond fun and games into the serious business of physical rehabilitation.
"This is new technology that may potentially help patients with a stroke," said study lead author Gustavo Saposnik, MD, director of the Stroke Outcomes Research Unit at St. Michael's Hospital at the University of Toronto, Canada. "We ran a pilot study to see whether this is doable, safe, and more effective than routine therapy," he said. "And we found it was."
The findings were presented at the international conference of the American Stroke Association in San Antonio, Texas.
The Study
The Wii gaming system-produced by Nintendo, which did not fund the study-allows players to physically interact in real-time with images on TV screens through the use of wireless motion detection remote controls.
To gauge the promise of a Wii-based rehabilitation program, Dr. Saposnik and his colleagues focused on 20 stroke survivors, average age 61, all of whom were recovering from mild to moderate ischemic (caused by blood vessel blockage) or hemorrhagic (bleeding) strokes.
The stroke survivors were randomly divided into two groups. One group participated in standard recreational therapy for impaired arms, involving the playing of card games or the block-stacking game Jenga The second group was assigned to Wii-based therapy, either playing virtual tennis or cooking virtually through "Wii Tennis" or "Wii Cooking Mama").
The Wii-based therapy involved movements that mimic the arm strokes required in a tennis match or those needed for cutting potatoes, peeling onions, slicing meat and shredding cheese.
Both the recreational and Wii-based therapies were administered in eight 60-minute sessions spread over two weeks. Both regimens, which were described by the researchers as "intensive," were launched within two months following stroke occurrence.
The Results
After two weeks, the Wii group showed greater improvements than the recreational group in the patients' affected arms, as measured in terms of the speed and grip strength necessary for normal motor function. No evidence of safety risk was found among the Wii group.
"Basically, we found that Wii therapy produced a 30% better improvement than recreational therapy in the time it took for the Wii patients to execute a task, and in how well they were able to execute a task," said Dr. Saposnik.
Implications
Dr. Saposnik said that if the apparent benefits of Wii therapy hold up to further scrutiny, the high-tech physical therapy approach could help address two paramount challenges patients face when embarking on a recovery program: time and access.
"Rehabilitation is time-consuming, which can translate into poor compliance," he noted. "And it's not always available to all patients, based on cost and insurance constraints. But the high-intensity, repetitive nature of Wii therapy seems to offer quick benefits, and it's widely available. So this could prove to be very helpful."
Larger Study Under Way
"However, this is just an initial step towards expanding our understanding of the potential benefit this kind of innovative, interactive approach in neurorehabilitation might have following a stroke," Dr. Saposnik cautioned.
"A larger study should be completed before making recommendations," he said. "And that is already under way."
Expert Reaction
William Meehan, MD, director of the Sports Concussion Clinic at Children's Hospital Boston, said Dr. Saposnik's early observation makes "a lot of sense."
"In general terms, the use of computer programs with some sort of motor movement component has certainly already been shown to be of benefit in terms of helping patients regain balance control when dealing with a sportsrelated concussion," he said. "So I think this whole rehabilitation approach has great promise.
"And it is much more convenient than normal therapy, in that patients could perhaps do this kind of thing at home," Dr. Meehan added. "But, I would say it will probably end up best being used to augment standard therapies, because you do always want an actual therapist to monitor patient progress."
Better Stroke Recovery
When researchers reviewed 14 studies involving 429 stroke patients, they found that a lower-leg splint supporting the foot and ankle-designed to keep joints properly aligned—immediately helped patients walk faster and improved balance, while an upper-limb splint (such as a wrist splint) did not improve function.
If a loved one has suffered a stroke: Ask his/her physical therapist or podiatrist whether a lower-leg splint might improve your loved one's mobility and balance.
Music Therapy for Stroke Patients
In a small study of men and women who suffered partial vision loss due to stroke, the patients were better able to identify shapes and lights while listening to music they enjoyed.
Theory: Pleasing music activates brain areas linked to positive emotional responses to stimuli, improving awareness of the visual world.
If you have experienced vision loss due to stroke: Ask your doctor whether music therapy might benefit you.
Antidepressant Improves Stroke Recovery
Stroke victims' learning and memory skills can be improved by the antidepressant Lexapro, according to a recent study.
Recent finding: Stroke patients who were given a 12-week course of escitalopram (Lexapro) after a stroke had higher scores on tests of verbal and visual memory. The drug, a selective serotonin reuptake inhibitor (SSRD, helped stroke recovery even if given as much as three months after the stroke, although it should be administered as soon as possible.
